I understand that my data will be strictly confidential. This clinic does not sell, share, or resell information.  I confirm that all information in this form is true and accurate. I confirm that if I hold some important information and complications happen, the clinic will not be liable. I release this clinic and hold harmless against any claims, expenses, damages, and liabilities. I acknowledge that after my service, my skin may experience tightness, dryness, redness, peeling, break-outs and/ or hyperpigmentation or scaring. Following more intense treatments I may experience slight swelling and/or blood spotting. Healing may take 24 hours to several days. Please be aware that anytime the skin is broken there is a slight risk of bacteria or viral infection. You must keep the treated area clean and dry for up to one week following your treatment. Moisturize and protect the newly exposed skin with adequate sunscreen (SPF 30 or higher), as you are more susceptible to sunburn and skin damage. 

-Because spa and facial services should not be performed under certain medical conditions, you affirm that you have stated all your known medical conditions honestly. You agree to keep your esthetician updated as to any changes of your skin or medical profile and understand that there shall be no liability on the esthetician's part should you fail to do so. 

-YOU UNDERSTAND AND VOLUNTARILY ACCEPT ANY RISKS ASSOCIATED WITH THIS SPA AND/OR FACIAL SERVICES OR ANY USE OR ESTHETICS.LA FACILITIES. ESTHETICS.LA WILL NOT BE LIABLE FOR ANY INJURY IR DAMAGES, INCLUDING, WITHOUT LIMITATION, PERSONAL, BODILY, ECONOMIC LOSS, OR ANY OTHER DAMAGE TO YOU OR ANY OTHERS RESULTING FROM THE NEGLIGENCE OF ESTHETICS.LA OR ANYONE ACTING ON BEHALF OF ESTHETICS.LA.

By signing below, I acknowledge that I have read and understood the foregoing informed consent and agree to the treatment with associated risks. I hereby agree to have this service performed and agree to follow all of the pre and post-treatment instructions.